Extracorporeal instrument knotting technique for minimal access thoracic surgery

Knot-tying technique is essential for surgery. We described here a novel instrument knotting technique that is simple, safe and useful in minithoracotomy. This technique was used on 14 consecutive patients that underwent selective minithoracotomy during the past half year. Both knot security and loop security could be easily achieved with this technique. No unraveling or dislodgement of the knot was noted. This method is simple, convenient and reliable to achieve secure flat square knots in limited, deep operating spaces. Its clinical advantages render it as a promising knot-tying technique that can be routinely used in a variety of thoracic surgery.